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Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients: results from the DANISH trial

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Boas, Rune ; Thune, Jens Jakob ; Pehrson, Steen ; Køber, Lars ; Nielsen, Jens C ; Videbæk, Lars ; Haarbo, Jens ; Korup, Eva ; Bruun, Niels Eske ; Brandes, Axel ; Eiskjær, Hans ; Thøgersen, Anna M ; Philbert, Berit T ; Svendsen, Jesper Hastrup ; Dixen, Ulrik. / Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients : results from the DANISH trial. I: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. 2021 ; Bind 23, Nr. 4. s. 587-595.

Bibtex

@article{e998e528fbb94d458bfd9bece8523a5c,
title = "Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients: results from the DANISH trial",
abstract = "Aims: Improved risk stratification to identify non-ischaemic heart failure patients who will benefit from primary prophylactic implantable cardioverter-defibrillator (ICD) is needed. We examined the potential of ventricular arrhythmia to identify patients who could benefit from an ICD. Methods and results: A total of 850 non-ischaemic systolic heart failure patients with left ventricle ≤35% and elevated N-terminal pro-brain natriuretic peptides had a 24-h Holter monitor recording performed. We examined present non-sustained ventricular tachycardia (NSVT), defined as ≥3 consecutive premature ventricular contractions (PVCs) with a rate of ≥100/min, and number of PVCs per hour stratified into low (<30) and high burden (≥30) groups. Outcome measures were overall mortality, sudden cardiac death (SCD), and cardiovascular death (CVD). In total, 193 patients died, 49 from SCD and 125 from CVD. Non-sustained ventricular tachycardia (365 patients) was significantly associated with increased all-cause mortality [hazard ratio (HR) 1.47; 95% confidence interval (CI) 1.07-2.03; P = 0.02] and to CVD (HR 1.89; CI 1.25-2.87; P = 0.003). High burden PVC (352 patients) was associated with increased all-cause mortality (HR1.38; CI 1.00-1.90; P = 0.046) and with CVD (HR 1.78; CI 1.19-2.66; P = 0.005). There was no statistically significant association with SCD for neither NSVT nor PVC. In interaction analyses, neither NSVT (P = 0.56) nor high burden of PVC (P = 0.97) was associated with survival benefit from ICD implantation. Conclusion: Ventricular arrhythmia in non-ischaemic heart failure patients was associated with a worse prognosis but could not be used to stratify patients to ICD implantation.",
keywords = "Implantable cardioverter-defibrillator, Non-ischaemic heart failure, Non-sustained ventricular tachycardia, Premature ventricular contractions, Ventricular arrhythmia",
author = "Rune Boas and Thune, {Jens Jakob} and Steen Pehrson and Lars K{\o}ber and Nielsen, {Jens C} and Lars Videb{\ae}k and Jens Haarbo and Eva Korup and Bruun, {Niels Eske} and Axel Brandes and Hans Eiskj{\ae}r and Th{\o}gersen, {Anna M} and Philbert, {Berit T} and Svendsen, {Jesper Hastrup} and Ulrik Dixen",
note = "Publisher Copyright: {\textcopyright} 2020 Published on behalf of the European Society of Cardiology. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = apr,
day = "6",
doi = "10.1093/europace/euaa341",
language = "English",
volume = "23",
pages = "587--595",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "4",

}

RIS

TY - JOUR

T1 - Prevalence and prognostic association of ventricular arrhythmia in non-ischaemic heart failure patients

T2 - results from the DANISH trial

AU - Boas, Rune

AU - Thune, Jens Jakob

AU - Pehrson, Steen

AU - Køber, Lars

AU - Nielsen, Jens C

AU - Videbæk, Lars

AU - Haarbo, Jens

AU - Korup, Eva

AU - Bruun, Niels Eske

AU - Brandes, Axel

AU - Eiskjær, Hans

AU - Thøgersen, Anna M

AU - Philbert, Berit T

AU - Svendsen, Jesper Hastrup

AU - Dixen, Ulrik

N1 - Publisher Copyright: © 2020 Published on behalf of the European Society of Cardiology. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/4/6

Y1 - 2021/4/6

N2 - Aims: Improved risk stratification to identify non-ischaemic heart failure patients who will benefit from primary prophylactic implantable cardioverter-defibrillator (ICD) is needed. We examined the potential of ventricular arrhythmia to identify patients who could benefit from an ICD. Methods and results: A total of 850 non-ischaemic systolic heart failure patients with left ventricle ≤35% and elevated N-terminal pro-brain natriuretic peptides had a 24-h Holter monitor recording performed. We examined present non-sustained ventricular tachycardia (NSVT), defined as ≥3 consecutive premature ventricular contractions (PVCs) with a rate of ≥100/min, and number of PVCs per hour stratified into low (<30) and high burden (≥30) groups. Outcome measures were overall mortality, sudden cardiac death (SCD), and cardiovascular death (CVD). In total, 193 patients died, 49 from SCD and 125 from CVD. Non-sustained ventricular tachycardia (365 patients) was significantly associated with increased all-cause mortality [hazard ratio (HR) 1.47; 95% confidence interval (CI) 1.07-2.03; P = 0.02] and to CVD (HR 1.89; CI 1.25-2.87; P = 0.003). High burden PVC (352 patients) was associated with increased all-cause mortality (HR1.38; CI 1.00-1.90; P = 0.046) and with CVD (HR 1.78; CI 1.19-2.66; P = 0.005). There was no statistically significant association with SCD for neither NSVT nor PVC. In interaction analyses, neither NSVT (P = 0.56) nor high burden of PVC (P = 0.97) was associated with survival benefit from ICD implantation. Conclusion: Ventricular arrhythmia in non-ischaemic heart failure patients was associated with a worse prognosis but could not be used to stratify patients to ICD implantation.

AB - Aims: Improved risk stratification to identify non-ischaemic heart failure patients who will benefit from primary prophylactic implantable cardioverter-defibrillator (ICD) is needed. We examined the potential of ventricular arrhythmia to identify patients who could benefit from an ICD. Methods and results: A total of 850 non-ischaemic systolic heart failure patients with left ventricle ≤35% and elevated N-terminal pro-brain natriuretic peptides had a 24-h Holter monitor recording performed. We examined present non-sustained ventricular tachycardia (NSVT), defined as ≥3 consecutive premature ventricular contractions (PVCs) with a rate of ≥100/min, and number of PVCs per hour stratified into low (<30) and high burden (≥30) groups. Outcome measures were overall mortality, sudden cardiac death (SCD), and cardiovascular death (CVD). In total, 193 patients died, 49 from SCD and 125 from CVD. Non-sustained ventricular tachycardia (365 patients) was significantly associated with increased all-cause mortality [hazard ratio (HR) 1.47; 95% confidence interval (CI) 1.07-2.03; P = 0.02] and to CVD (HR 1.89; CI 1.25-2.87; P = 0.003). High burden PVC (352 patients) was associated with increased all-cause mortality (HR1.38; CI 1.00-1.90; P = 0.046) and with CVD (HR 1.78; CI 1.19-2.66; P = 0.005). There was no statistically significant association with SCD for neither NSVT nor PVC. In interaction analyses, neither NSVT (P = 0.56) nor high burden of PVC (P = 0.97) was associated with survival benefit from ICD implantation. Conclusion: Ventricular arrhythmia in non-ischaemic heart failure patients was associated with a worse prognosis but could not be used to stratify patients to ICD implantation.

KW - Implantable cardioverter-defibrillator

KW - Non-ischaemic heart failure

KW - Non-sustained ventricular tachycardia

KW - Premature ventricular contractions

KW - Ventricular arrhythmia

UR - http://www.scopus.com/inward/record.url?scp=85104047168&partnerID=8YFLogxK

U2 - 10.1093/europace/euaa341

DO - 10.1093/europace/euaa341

M3 - Journal article

C2 - 33257933

VL - 23

SP - 587

EP - 595

JO - Europace

JF - Europace

SN - 1099-5129

IS - 4

M1 - euaa341

ER -

ID: 61372720